Individual
DR. CAROL A. PASTORE-WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1221 W 5TH ST, SHERIDAN, WY 82801-2701
(307) 674-4405
Mailing address
1221 W 5TH ST, SHERIDAN, WY 82801-2701
(307) 674-4405
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
304
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22448
MEDICARE PTAN
WY
Enumeration date
03/23/2007
Last updated
12/09/2009
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